This study was undertaken to determine whether verapamil protects renal function in rabbits with ischemic acute renal failure. Renal ischemia was induced by clamping bilateral renal arteries for 60 min. One group received intravenously an infusion of verapamil (lmg/kg) for 30 min prior to initiation of renal artery clamping and the other group received equal volume of saline. Renal blood flow was measured with flowmeter before (basal) and 24 hr after ischemia. Serum creatinine level increased 24 hr after ischemia and remained high to 72 hr. When verapamil was pretreated, the level 48 and 72 hr after ischemia was significantly decreased compared with saline insusion. Urine flow was markedly decreased 24 hr after ischemia and remained depressed to 72 hr, but it was significantly increased 72 hr after ischemia in verapa- mil-pretreatment animals as compared with the saline-infusion animals. GFR were markedly reduced 24 hr after ischemia and remained depressed to 72 hr, which was significantly prevented by verapamil pretreatment. Ischemia caused a significant increase in FEVa and a reduction in Uosm, and TcH2O, indicating impairment in urine concentrating ability of tubules, and the impairment was significantly attenuated by verapamil. The uptake of p-aminohippurate in cortical slices was depressed by ischemia, which was significantly prevented by verapamil pretreatment. In salineinfusion animals, renal blood flow was not significantly different between the basal value and that after 24 hr of reflow. Renal blood flow was not significantly altered by verapamil pretreatment. Anoxia/reoxygenation injury in the control renal slices was not significantly prevented by Ca channel blockers. These results suggest that verapamil exerts a protective effect in ichemic acute renal failure, and the beneficial effects may be attributed to effects other than vasodilation. These data also indicate that a reduction in GFR following ischemia does not result from change in renal blood flow.
Acute Kidney Injury* ; Animals ; Constriction ; Creatinine ; Flowmeters ; Ischemia ; Kidney Concentrating Ability ; p-Aminohippuric Acid ; Rabbits* ; Renal Artery ; Renal Circulation ; Vasodilation ; Verapamil*

OBJECTIVES: Stress management is related to public healthcare and quality of life; an accurate stress classification method is necessary for the design of stress monitoring systems. Therefore, the goal of this study was to design a novel stress classification model using a deep learning method. METHODS: In this paper, we present a stress classification model using the dataset from the sixth Korea National Health and Nutrition Examination Survey conducted from 2013 to 2015 (KNHANES VI) to analyze stress-related health data. Statistical analysis was performed to identify the nine features of stress detection, and we evaluated the performance of the proposed stress classification by comparison with several stress detection models. The proposed model was also evaluated using Deep Belief Networks (DBN). RESULTS: We designed profiles depending on the number of hidden layers, nodes, and hyper-parameters according to the loss function results. The experimental results showed that the proposed model achieved an accuracy and a specificity of 66.23% and 75.32%, respectively. The proposed DBN model performed better than other classification models, such as support vector machine, naive Bayesian classifier, and random forest. CONCLUSIONS: The proposed model in this study was demonstrated to be effective in classifying stress detection, and in particular, it is expected to be applicable for stress prediction in stress monitoring systems.
Classification* ; Dataset ; Delivery of Health Care ; Forests ; Korea ; Learning ; Machine Learning ; Methods ; Nutrition Surveys ; Quality of Life ; Sensitivity and Specificity ; Support Vector Machine

BACKGROUNDS: Percutaneous radiofrequency neurotomy of posterior primary ramus has been in use as a treatment for persistent, mechanical low back pain for two decades. However, there has been limited studies regarding to prognostic factors related to outcome. We report our experience with at least 2-year follow up with special aftention on prognostic factors. METHODS: Of total 228 patients who underwent percutaneous radiofrequency neurotomy (PRN) of posterior primary ramus for refractory low back pain during last 3 years, 128 patients whose pain was considered to be originated from facets joints or their surrounding soft tissue and responded to temporary blocks were assigned to a group II. All patients had more than 6 months of pain. These patients were compared with 100 patients to whom PRN were provided for chronic nonspecific low back pain without all inclusion criteria (Group I). RF procedures were done under local anesthesia with C-arm intensifier guidance. Pain reliefs were estimated at 1week, 1month, 6months and 2 years using visual analog scale(VAS). For patients with more that 50% reduction of previous pain was regarded as positive responder. Various clinical variables such as age, sex, symptom duration, types of pain, bilaterality, and previous surgery were studied for prognostic factors. RESULTS: Positive responders were 56% at 1week, 46% at lmonth, 18% at 6months, and 13% at 2years after PRN in group I, and 78.9% at lweek, 75.4% at lmonth, 62.5% at 6months, and 54.7% at 2years in group II. Some variables were found to be significantly related to outcome including prominent local tenderness, percussion tenderness, combination of symptoms with pain on gefting up, extension, transitional movement, pain radiating to buttock and/or posterior thigh, and good immediate response. Age, sex, symptom duration, bilaterality, imaging study results, previous lumbar surgery, and degrees of pain relief from diagnostic block were not related to outcome. CONCLUSIONS: These results indicate that PRN of posterior primary ramus has a moderate overall long-term beneficial effect, with no morbidity in our series. But, the long-term good results will be anticipated only in properly selected patients with low back pain originating from facet joints and surrounding structures.
Anesthesia, Local ; Buttocks ; Follow-Up Studies ; Humans ; Joints ; Low Back Pain* ; Percussion ; Thigh ; Zygapophyseal Joint

In a conservative treatment of lumbar disc herniation, authors customarily had included the flexion exercise untill 1991. Thereafter, the extension exercise started to be included for the selected patients and this study was designed to assess the clinical outcome of the extension exercise compared to the flexion exercise in the conservative treatments of lumbar disc herniations. 55 consecutive patients (31 males and 24 females having ages ranging from 19-68 years with a mean of 37.2) were included in this prospective study. Criteria for inclusion in this group were: 1. Contained herniations of a single lumbar disc, documented by CT or MRI; 2. no other concurrent spine pathology; 3. conservative treatments with an uniform program including the extension exercise; 4. follow-up for a minimum of one year. For comparison with this prospective group, another 62 consecutive patients (36 males and 26 females having ages ranging from 17-63 years with a mean of 35.7) were selected who were treated during 1991 with flexion exercise before this study was designed and who were matched with the designed criteria except for the direction of exercise. Apart from the therapeutic exercise, the conservative treatments also included medication, physiotheraphy, epidural injection, and back school in the both groups uniformly. The clinical outcome of the extension exercise group indicated that 28 (50.9%) patients excellent, 23 (41.8%) patients good, three (5.5%) patients fair, and one (1.8%) patient failed outcomes. In the flexion exercise group, there were 23 (37.1%) excellent, 27 (43.5%) good, seven (11.3%) fair, and five (8.1%) failed outcomes. From these results, it would seem to follow that the extension exercise group had superior clinical outcome compared to the flexion exercise, i.e. higher excellent and good outcomes (92.7% vs. 80.6%) and lower poor and failed outcomes (7.3% vs. 19.4%), respectively, Moreover, the excellent outcome in terms of full recovery without any pain and disability was more common in the extension exercise group (50.9% vs. 37.1%). A better clinical outcome was obtained in the extension exercise group of patients who were younger than 40 years and who had a history of three months or less compared with those who were older and had longer history of disease. The sizes of disc protrusion did not affect the clinical outcome. In conclusion, we would recommend that the extension exercise, instead of the flexion exercise, should be included in the conservative treatment of a contained herniation of lumbar disc for a better clinical outcome.
Female ; Follow-Up Studies ; Humans ; Injections, Epidural ; Magnetic Resonance Imaging ; Male ; Pathology ; Prospective Studies ; Spine

A clinical review and analysis was carried out on 14 cases of ischemic myositis associated with carbon monoxide poisioning treated at S.N.U.H. during the 3 year period from 1968 to 1971 with following results. l. Among 14 patients, there were 8 males and 6 females. 8 cases were between the 20–30 years of age. None was observed under 20 years old. 2. Average duration of exposure to carbon monoxide gas was 9 hours, mostly between 8–12 hours. 3. Such systemic conditions are suggested as predisposing causes leading to ischemic myositis as pregnancy, postpartum, active pulmonary tuberculosis, obesity with hypertension, and hypnotic addiction. 4. In regard to the local factors, prolonged external pressure the body is subjected to in unconcious state as well as local burn is shown to be responsible for the myositis. And in this respect Korean mode of bed on On-Dol may deserve blame for myositis because of its hardness and much heat. 5. Complications associated with ischemic myositis were 3 cases of ischemic myocarditis, 2 cases of brain syndrome and 3 cases of acute renal failure. In 3 cases of renal failure, all terminated fatally inspite of the intensive care including hemodialysis. 6. Fasciotomy should be performed cautiously, as 4 cases of secandary infection were complicated after fasciotomy on 5 cases.
Acute Kidney Injury ; Brain ; Burns ; Carbon Monoxide Poisoning ; Carbon Monoxide ; Carbon ; Critical Care ; Female ; Hardness ; Hot Temperature ; Humans ; Hypertension ; Male ; Myocarditis ; Myositis ; Obesity ; Postpartum Period ; Pregnancy ; Renal Dialysis ; Renal Insufficiency ; Tuberculosis, Pulmonary

PURPOSE: We present a case of Erdheim-Chester disease (ECD) with diplopia. CASE SUMMARY: A 56-year-old woman came to the hospital with a 6-week history of diplopia on left lateral gaze. The right eye showed mildly limited adduction. Humphrey automated perimetry demonstrated inferior bitemporal quadrantanopia. Orbital and brain magnetic resonance imaging revealed well-defined orbital masses in both intraconal orbits with homogenous enhancement, as well as multiple masses of homogenous signal intensity in the brain. Systemic evaluation showed involvement of the long bones, and retroperitoneum, but no involvement of the heart, or lungs. Incisional biopsy of the right orbital mass was performed. Histopathological examination showed numerous lipid-laden histiocytes and few multinucleated Touton giant cells. Immunohistochemical staining showed positivity for CD68, but negativity for CD1a, and ECD was therefore diagnosed. The patient received treatment with radiation therapy and interferon-alpha, but died due to sepsis secondary to urinary tract infection after 2 months. CONCLUSIONS: Except exophthalmos, diplopia may be the only initial symptom of an orbital mass. Although rare, the possibility of ECD should be considered in the differential diagnosis of both retrobulbar and orbital masses with diplopia.
Biopsy ; Brain ; Diagnosis, Differential ; Diplopia* ; Erdheim-Chester Disease* ; Exophthalmos ; Female ; Giant Cells ; Heart ; Hemianopsia ; Histiocytes ; Humans ; Interferon-alpha ; Lung ; Magnetic Resonance Imaging ; Middle Aged ; Orbit ; Sepsis ; Urinary Tract Infections ; Visual Field Tests

The aim of this study was to examine the effect of phase I cardiac rehabilitation program (CRP) on physical capacity in patients with coronary artery bypass graft (CABG). Eighty seven patients who underwent CABG in our hospital were enrolled on the study. Among them, excluding 17 during the study, the results of 70 patients were included in the final data. Subjects were classified into two groups according to the participation in the phase I CRP; participation group (n=35) and non-participation group (n=35). The CR was executed for the participation group until patients' discharge. The variables including resting heart rate (RHR), oxygen saturation, walking distance in 6 minutes, and forced expiration amount were measured at initial phase, discharge and follow-up at 1 month after discharge. From the data, descriptive statistics (mean, standard deviation) were calculated, and differences in each variable before, during, after the treatment and between groups were tested using repeated measure analysis of variance using SPSS ver. 18.0 statistics program for Window. For the effects and results with a statistical significance, post-hoc test was made using t-test. There was statistically significant difference (p<0.05) in the RHR and the walking distance in 6 minutes. While there was no significant difference in the oxygen saturation and the maximum expiration amount. As conclusion, the Phase I CRP after CABG showed a effect on the significant improvement of physical capacity by decreasing the RHR and increasing the walking distance in 6 minutes, exerting a positive influence on the recovery after the CABG operation.
Coronary Artery Bypass ; Coronary Vessels ; Follow-Up Studies ; Heart ; Heart Rate ; Humans ; Oxygen ; Transplants ; Walking

OBJECTIVE: To analyze the interrelationship between homocysteine and methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: Homocysteine and MTHFR mutation were tested by fluorescent polarizing immunoassay and PCR-RFLP method, respectively. RESULTS: In patients with homocysteine level less than 5 mmol/L, there was no case of normal group but there were four cases of heterozygosity and one case of homozygosity. In patients with homocysteine level 5~10 mmol/L, the number of normal, heterozygosity and homozygosity group were eleven, eighteen and eight, respectively. In patients with homocysteine level 10~15 mmol/L, the number of normal, heterozygosity and homozygosity group were four, one and one, respectively. In patients with homocysteine level more than 15 mmol/L, there was no case of normal and heterozygosity group but there were two cases of homozygosity. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. And there was a significant relationship between homocysteine and MTHFR mutation.
Abortion, Spontaneous* ; Female ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

No abstract available.
Amphotericin B* ; Hemoptysis*

BACKGROUND: Although impaired endothelial function is well known in patients with diabetes mellitus, the precise mechanism and the factors that contribute to this dysfunction remain to be clarified. We examined the effect of acute hyperglycemia on patients with impaired glucose metabolism in vivo by plethysmography. METHODS: Seven patients with diabetes mellitus or impaired glucose metabolism were studied. In each patient, endothelial function was examined in the fasting state and at two levels of hyperglycemia, which were achieved by the infusion of glucose, insulin, and somatostatin. Forearm blood flow was measured while acetylcholine was infused in increasing concentrations(7.5, 15, and 30 microgram/min) through the brachial artery. RESULTS: Glucose concentrations increased accordingly at each stage, from 135.3+/-18.4 mg/dl at stage 1(the fasting state), to 239.0+/-15.2 mg/dl at stage 2(the first level of hyperglycemia), and to 378.3+/-25.3 at stage 3 (the second level of hyperglycemia) [p<0.01]. Maximal acetylcholine-dependent vasodilation achieved by infusion of acetylcholine at 30 microgram/min was significantly aftenuated during stages 2 and 3 compared with stage 1(p<0.05 by AVOVA; forearm blood flow ratio was 2.87+/-0.18 and 2.56+/-0.14 versus 3.58+/-0.21, respectively). This was also evident during the infusion of 15 microgram/min and 7.5 microgram/min of acetylcholine. CONCLUSIONS: Endothelium-dependent vasodilation is significantly aftenuated by acute hyperglycemia in patients with diabetes mellitus or impaired glucose metabolism. Our findings suggest that elevated glucose may contribute to the endothelial dysfunction observed in patients with diabetes mellitus or impaired glucose metabolism.
Acetylcholine ; Brachial Artery ; Diabetes Mellitus* ; Endothelium ; Fasting ; Forearm ; Glucose* ; Humans ; Hyperglycemia* ; Insulin ; Metabolism* ; Plethysmography ; Somatostatin ; Vasodilation*